Axe GP program if you must, but at least keep rebate: AMA plea

September 23, 2014

The AMA has called on the Federal Government to maintain full rebate access for prevocational GP trainees in light of its decision to axe a well-regarded placement program for junior doctors interested in general practice as a career.

AMA President Associate Professor Brian Owler has written to Health Minister Peter Dutton urging him to continue to provide access to A1 Medicare rebates for GP trainees even after the Prevocational General Practice Placements Program (PGPPP) is wound up on 1 December.

“PGPPP is a valuable program for many reasons,” A/Professor Owler said. “It supports efforts to deliver more training and care in the community, supplementing the traditional hospital-based approach to medical training.”

The Program is administered by General Practice Education and Training, and the Government announced in its May Budget that both would be wound up as part of wholesale cuts to GP training which would save the Commonwealth $115.4 million over four years.

The AMA has expressed deep concern over the changes.

In his speech to the National Press Club in July, A/Professor Owler said the loss of the PGPPP would “hit hard” while the abolition of GPET and its absorption into the Health Department would, combined with an overhaul of regional training providers, put the integrity of GP training at risk.

The AMA President witnessed the benefits of the PGPPP program first hand during a recent visit to Aboriginal community controlled health centres in the Northern Territory.

He met with junior doctors who, through the PGPPP, had been given the opportunity to work in clinics operated by the Central Australian Aboriginal Congress.

A/Professor Owler said the program not only helped broaden the experience of trainee doctors but, through careful targeting, “has also boosted access to GP services in rural and remote communities”.

Several State and Territory governments are understood to be considering stepping in to fund a number of PGPPP-style places, particularly in rural and remote areas.

But A/Professor Owler warned such efforts were unlikely to be successful if the entitlement given to PGPPP trainees to deliver Medicare-funded services at the A1 rebate level was lost.

He urged Mr Dutton to consider supporting State and Territory efforts by extending this entitlement beyond the closure of the PGPPP program.

“The costs of maintaining access to A1 Medicare rebates would be negligible in the context of overall Medicare spending…[but] is essential to encouraging the involvement of practices [and] ensuring that patients are treated equally, regardless of whether they see a prevocational trainee, GP trainee or fully qualified GP,” the AMA President wrote.

The alternative, a return to a situation in which prevocational medical training is delivered solely in hospitals, is “not in step with the direction of modern medical education,” he said.